HomeMy WebLinkAboutH2023-0379 - Permits�EwPOR� City of Newport Beach II�II INIIINIII��NIIIIN III
p� Community Development Department - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
G Permit Counter Phone: (949) 718-1888
newporibeachca.gov/civic -� �> �• k- ���,
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Mechanical Permit
Plan Check No:
Work Class : Other
Issued Date : 06/0812023
Inspection Area : 8
H2O23-0379
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE
NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS
Job Address : 1224 PEMBROKE LN
Legal Desc : N TR 3607 BLK LOT 5
Description: MECH REROUTE DUCTWORK FOR FAU "`STOP WORK 123-1757•'
Owner: BRIAN LOYOLA
Contractor
Address: 555 ANTON BLVD, 150 COSTA MESA, CA 92626
; Address':
Phone: (714) 235-3572
Phone :
Con State Lic
Applicant: BRIAN LOYOLA
Lic Expire:
Address : 555 ANTON BLVD, 150 COSTA MESA, CA'92626
Bus Lic`: -
Phone : (714) 235-3572
Bus Lic Expire:
Workers' Compensation Insurance
Owner/Builder: BRIAN LOYOLA
Carrier:
Address: 555 ANTON BLVD, 150 COSTA MESA, CA 92626
Policy No:
Phone : (714) 235-3572
W. C. Expire:
Code Edition: 2022
Fire Hazard Zone ; NO Manufacturer
Type of Construction :
Model# :
Occupancy Groups:
Building Setbacks : Front: 20, Side: 4, Side: 4, Rear: 10 `
Flood Zone: X
Use Zone: R-1 - Single -Unit Residential
PROCESSED BY: l% 7
SPECIAL CONDITIONS: STOPWORK 123-1757
as owner of the property, or my employee$ with wages as their sole compensation, will do: (_)
ess and Professions Code: The bontractors' Slate License Law does not apply to an owner o
vements are not Intended or offered for sale, If, however, the building or Improvement is sold
ved for the purpose of sale),
as owner of the property, am exclusivelycomreoong with licensed Contractors to construct th
to an owner of property who builds or Improves thereon, and who contracts for the projects
my
Is
of
affirm under peneity of perjury that am`Iicam
cL License Class.
sRS' COMPENSATION DECLARATION
penalty of
or personal effort, builds or improves the properly, provided that the
(honer -Builder will have the burden of proving that It: was not built or
,Ines$ and Professions Code; The Contractors' State License Law does not
suentto the Contractors' State License Law),.
and my license Is In full force.
CRUNAL PENALTEs AND Cw LPelao UP To ONE HUNDRED THOUSAND DOLLARS (0104,000), rk AMMON TO THE
mby affirm under penairy of perjury Ono of the following declarations:
I have And will: maintain a certlticate. Of consent to self -Insure tar workers' compensation, Issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for
banance of the work for which (his permit Is Issued, Policy No.
have,and will maintain workers' compensation Insurance, as. required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compenea
Nance carrier and policy number are:
rier Policy Number Expiration Data
iof Agent
certify that, in the performance
, If I should become Subject to l
Name
for which this permit is Issued, I shall not employ any person in any manner so as to become subject to the workers' compensa)Ion laws of California,. and ogre
compensation provisions of Section 3100 of the Labor Code, I shall forthwith comply with those provisions.
Date b6 4/z-oZ�
lending agency for the performance of the work for which this permit Is: issued (Seollon 3097,: Civil Code),
Lenders Address
-
I am the property owner or aal�rbted 10 act on the property owner's behalf.
(have read ft 7apication and the Information I have provided is correct.
t agree to com.1y vilh all oppliceblee)tyand county one and state laws relating to
I ev+hortta ro"s it tatives of this city or couhry to t th bovedtlantifted property. fort
P`NLrlr PMAL I 9-27_Z aE9TOSNgTIF1A fIS1f�1$.NOTAPPLIC"LE TO
WITIFICATEOP PROPOSED OEMOUTt